Estimate and Evaluation of Drug Nephrotoxicity Caused with Most Used Medicals in Patients with Rheumathoid Arthritis
Journal Title: Archives of Clinical Nephrology - Year 2016, Vol 2, Issue 1
Abstract
Aim: To estimate the effect of initial therapy with Paracetamol (Acetaminophenum) and nonsteroidal anti-inflamatory drugs (Ketoprofenum) on glomerular and tubular integrity in patients with Rheumatoid arthritis (RA), to quantify toxicity of these drugs through measurements of the enzyme excretion that correlates with the damage degree on the tubular epithelium. Microalbuminuria is used as marker for glomerular damage, and the urinary excretion of N-Acetyl-β-D-glucozaminidase (NAG) as an indicator of proximal tubular damage. To determine if there is a change in the clinical indicators of renal function (serum urea and creatinine, urine urea and creatinine, glomerular filtration rate - GFR) in the course of disease and if that change correlates with the dynamics of the quantity of excreted enzymes in urine, reactants of the acute pfase and index of disease activity (DAS28). Methods: Using the colorimetric method for determination of NAG, as well as immunoturbidimetric immunoturbidimetric assay for detection of microalbuminuria, we examined samples of 70 participants (35 RA pts treated only with Paracetamol, 35 RA pts treated with Ketoprofen), followed up in five time intervals in the course of 24 weeks. Rheumatoid factor (RF) is determined with the agglutination test (Lateks RF test) in the same participants. Results: there is a weak correlation between NAG and microalbuminuria (r=0.16) in the group of patients treated with Paracetamol, while in the group treated with Ketoprofen there is moderate correlation (r=0.28). NAG enzymuria in range, in number of examined patients and in time of appearance is greater and appears earlier in the group with Ketoprofen compared with the group of Paracetamol. Conclusions: Ketoprofen is more potent NAG inductor and triggers greater tubular enzymuria than Parcetamol.
Authors and Affiliations
Spasovski Dejan
Keywords
Related Articles
- EP ID EP344843
- DOI 10.17352/acn.000012
- Views 89
- Downloads 0
Bioimpedance: Innovative Approach in Nephrology and Autoimmune Diseases
The composition of the human body is considered a useful diagnostic tool in many medical specialties. The recognition of changes in nutrition and hydration of patients is useful in nephrology and in particular in chronic...
Echinocandins and Continuous Renal Replacement Therapies: The Role of Adsorption
The following reviews [1,2], about continuous renal replacement therapies (CRRT) and echinocandins conclude that the membranes do not significantly adsorb these antifungals.
Phenazopyridine abuse presenting with acute kidney injury, hemolytic anaemia and jaundice
Phenazopyridine, an azo dye, is commonly used to relieve dysuria caused by bladder irritation or infection. We report the case of a 64-year-old lady who presented with unexplained sub-acute onset hemolytic anaemia follow...
ANCA-Associated Vasculitis in Patient with CREST-Syndrome - Case Report
Background: ANCA-associated vasculitis is a small vessel necrotizing vasculitis with few or no immune deposits, necrotizing glomerulonephritis is very common in the microscopic poliangiitis subset. Systemic scleroderma r...
Current State of Tolerance: The Holy Grail
Research in Tolerance and Chimerism by Transplant immunologists for over half a century is akin to the pursuit of the Holy Grail. Animal experiments for inducing tolerance may not have been successful initially but in th...